Maintaining optimal heart health is paramount for overall well-being. With the advent of technology, ongoing research is looking to identify both risk factors and preventive measures against heart-related issues. A recent study, presented at the European Society of Cardiology (ESC) Congress 2023, revealed a significant correlation – individuals exhibiting superior exercise performance demonstrated a reduced likelihood of developing abnormal heart rhythms, known as AFib, as well as a diminished risk of experiencing serious cardiovascular events.(1) Read on to find out if it is actually possible to mitigate the risk of AFib and stroke through physical activity.
Physical Activity and Risk of AFib
According to a recent single-center study, lower physical fitness heightens the risk of developing atrial fibrillation (AFib). The study focused on adults without a prior AFib diagnosis who underwent exercise treadmill testing for clinical reasons.(2)
Researchers assessed the participants’ fitness levels using metabolic equivalents (METs), a measure of exercise intensity. Higher MET scores generally indicate better physical fitness and performance capabilities. Those who achieved the highest MET measures during treadmill testing, indicating the ability to exercise at the highest intensity, demonstrated an 8% lower risk of developing AFib, a 12% reduced risk of ischemic stroke, and a 14% decreased risk of major adverse cardiovascular events (MACE).(3)
Approximately 15,450 participants were involved in the study, with a follow-up period of just under eleven and a half years. Throughout the study, 515 new cases of AFib were recorded. The analysis took into account various variables, including age, hypertension, and medication usage. The findings highlighted the connection between better physical performance and improved heart health.
The study’s conclusion was that enhanced exercise performance correlates with a lower risk of AFib incidence, decreased incidence of ischemic stroke, and reduced risk of MACE.
One must stress upon the study’s significance in underlining the importance of regular physical activity. Sedentary individuals with lower physical fitness levels tend to face a higher risk of developing AFib, as well as an increased likelihood of the condition progressing. This relationship is likely due to a combination of structural, hormonal, and inflammatory changes that occur during inactivity, akin to how physical activity can protect against other cardiac issues like hypertension and coronary heart disease.(5)
What Exactly Happens in Atrial Fibrillation (AFib)?
Atrial fibrillation, characterized by irregular or rapid heartbeats in the upper chambers of the heart, significantly elevates the risk of blood clots and subsequent strokes. Several factors contribute to the likelihood of developing AFib, including advanced age, specific genetic predispositions, and lifestyle choices such as excessive alcohol consumption, smoking, or high levels of stress.(5)
Medical experts emphasize the seriousness of AFib, highlighting its potential for adverse outcomes including stroke, hospitalization, heart failure, cognitive impairment (dementia), and even premature mortality. Recognizing and promptly addressing AFib and its associated conditions is crucial in mitigating these risks.(6,7)
Treatment strategies for AFib encompass the modification of certain risk factors, along with the use of medications or surgical interventions. The current study sought to investigate the influence of exercise performance and physical fitness on the risk of developing atrial fibrillation.(8)
Research Limitations and What the Future Holds
While this study provides valuable insights, it comes with certain constraints. Firstly, it cannot establish a definitive causal relationship between exercise and the health outcomes examined. Additionally, the data appears to have been collected from a single center, which suggests the necessity for further investigation in this field.
Experts in preventive cardiology have underscored that being a retrospective, single-center study has certain limitations as compared to a prospective, multicenter approach, which would minimize potential biases. Given that the subjects underwent exercise treadmill testing for clinical reasons related to cardiovascular concerns, it implies that factors beyond mere activity levels and fitness may be significant considerations.
So, while higher exercise performance was associated with a lower incidence of AFib, as well as a reduced incidence of ischemic stroke and MACE, there are potential confounding factors in demographic baseline characteristics that warrant deeper exploration.”
Despite these limitations, the study’s findings underscore the pivotal role of physical activity in mitigating the risk of heart-related issues. The findings also underscores the need for interventional studies to ascertain the most effective strategies for helping patients comprehend the significance of exercise and integrate it into their daily routines.
Other Benefits of Being Physically Active
Engaging in regular physical activity offers a wide range of benefits beyond your cardiovascular health. It contributes to overall well-being and can have positive effects on various aspects of physical and mental health. Some of the key additional benefits of being physically active include:(9,10)
- Weight Management: Regular exercise helps regulate weight by burning calories and building lean muscle mass.(11)
- Improved Mental Health: Physical activity stimulates the release of endorphins, chemicals in the brain that promote feelings of happiness and reduce stress and anxiety. (12)
- Enhanced Bone Health: Weight-bearing exercises help increase bone density, reducing the risk of osteoporosis and fractures.
- Better Sleep Quality: Regular physical activity can improve the quality of sleep, helping individuals fall asleep faster and enjoy deeper, more restful sleep.(13)
- Improved Cognitive Function: Exercise has been shown to enhance cognitive functions like memory, attention, and learning.(14)
- Boosted Immune System: Regular activity supports a healthy immune system, reducing the risk of illness and promoting faster recovery.(15)
- Reduced Risk of Chronic Diseases: Physical activity can lower the risk of developing chronic conditions such as type 2 diabetes, certain cancers, and hypertension.
- Improved Mood and Mental Well-being: Exercise can help alleviate symptoms of depression and anxiety, and may even be used as part of treatment plans for mental health conditions.
- Increased Energy Levels: Regular physical activity improves cardiovascular health and endurance, leading to increased energy levels and reduced feelings of fatigue.
- Enhanced Social Interaction: Participating in group activities or team sports provides opportunities for social interaction, fostering a sense of belonging and community.
- Improved Balance and Coordination: Engaging in activities that challenge balance and coordination can help prevent falls and improve overall stability.
- Longevity and Quality of Life: Studies have shown that regular physical activity is associated with a longer lifespan and an improved overall quality of life.(16)
It is important to note that the type and intensity of physical activity can vary based on individual preferences and abilities. Finding activities that one enjoys can make it more likely to maintain a consistent exercise routine. Always consult with a healthcare provider before starting a new exercise program, especially if you have any underlying health conditions.
Conclusion
The link between regular physical activity and a reduced risk of atrial fibrillation (AFib) and stroke is a compelling testament to the power of exercise in promoting heart health. The evidence presented in this study underscores the importance of incorporating physical fitness into daily life as a proactive measure for cardiovascular well-being. While this study provides valuable insights, ongoing research and interventional studies are essential to further understand and implement effective strategies for encouraging and sustaining physical activity in individuals at risk for AFib and related conditions. By prioritizing an active lifestyle, individuals can not only enhance their cardiovascular health but also enjoy a myriad of additional benefits that contribute to overall well-being and quality of life.
- (No date) ESC Congress. Available at: https://www.escardio.org/Congresses-Events/ESC-Congress (Accessed: 07 September 2023).
- Ofman, P., Khawaja, O., Rahilly-Tierney, C.R., Peralta, A., Hoffmeister, P., Reynolds, M.R., Gaziano, J.M. and Djousse, L., 2013. Regular physical activity and risk of atrial fibrillation: a systematic review and meta-analysis. Circulation: Arrhythmia and Electrophysiology, 6(2), pp.252-256.
- Park, S., Han, K., Lee, S., Kim, Y., Lee, Y., Kang, M.W., Park, S., Kim, Y.C., Han, S.S., Lee, H. and Lee, J.P., 2020. Association Between Moderate‐to‐Vigorous Physical Activity and the Risk of Major Adverse Cardiovascular Events or Mortality in People With Various Metabolic Syndrome Status: A Nationwide Population‐Based Cohort Study Including 6 Million People. Journal of the American Heart Association, 9(22), p.e016806.
- Lloyd-Jones, D.M., Wang, T.J., Leip, E.P., Larson, M.G., Levy, D., Vasan, R.S., D’Agostino, R.B., Massaro, J.M., Beiser, A., Wolf, P.A. and Benjamin, E.J., 2004. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation, 110(9), pp.1042-1046.
- Nattel, S., 2002. New ideas about atrial fibrillation 50 years on. Nature, 415(6868), pp.219-226.
- Pritchett, E.L., 1992. Management of atrial fibrillation. New England Journal of Medicine, 326(19), pp.1264-1271.
- Lip, G.Y. and Tse, H.F., 2007. Management of atrial fibrillation. The Lancet, 370(9587), pp.604-618.
- Davies, M.J. and Pomerance, A., 1972. Pathology of atrial fibrillation in man. British heart journal, 34(5), p.520.
- Warburton, D.E., Nicol, C.W. and Bredin, S.S., 2006. Health benefits of physical activity: the evidence. Cmaj, 174(6), pp.801-809.
- Kannel, W.B. and Sorlie, P., 1979. Some health benefits of physical activity: the Framingham Study. Archives of internal medicine, 139(8), pp.857-861.
- Goldberg, J.H. and King, A.C., 2007. Physical activity and weight management across the lifespan. Annu. Rev. Public Health, 28, pp.145-170.
- Stănescu, M. and Vasile, L., 2014. Using physical exercises to improve mental health. Procedia-Social and Behavioral Sciences, 149, pp.921-926.
- Wang, F. and Boros, S., 2021. The effect of physical activity on sleep quality: a systematic review. European Journal of Physiotherapy, 23(1), pp.11-18.
- Davey, C.P., 1973. Physical exertion and mental performance. Ergonomics, 16(5), pp.595-599.
- Brines, R., Hoffman-Goetz, L. and Pedersen, B.K., 1996. Can you exercise to make your immune system fitter?. Immunology today, 17(6), pp.252-254.
- Shephard, R.J., 1996. Habitual physical activity and quality of life. Quest, 48(3), pp.354-365.